If you don’t already, you can follow me on Instagram @mothers.wellness.toolkit – I share there lots of postnatal healing and pelvic floor information, and Pelvic Floor Meditation live on Insta at 7.30pm on Mondays, which stays on my stories for 24 hours.
But I’m a mum – I don’t have any time!
Remember there is never a “perfect time” to focus on your postnatal rehab. You have to build it in to the time you already have and try not to feel that it’s a “to do” pressure to feel the weight of. Doing 3 minutes here, 3 minutes there is much more valuable for your core health than trying to make time for an hour a week.
It doesn’t have to be a “full workout” to be effective. 7 minutes a day is valuable, remember. Build it up as and when you can. When pushing your buggy or baby wearing, take a moment regularly to breathe, really fully deeply breathe and soften your shoulders.
Your mum posture day to day
Check in at least once a day with how you are carrying yourself. Either stretch against the wall: stand against the wall facing perpendicularly away, place your hand onto the wall. The rotate away from the wall, straightening your arm. You should feel a stretch in your pecs. Or: lie on your back with your arms outstretched and draw snow angels in the floor.
Most importantly, think about your A, B, Cs: Alignment, Breathing, Centring, with your every day movement.
Alignment: release yourself into the ground at least once a day: lie down, breathe, soften, legs up the wall is ideal.
Align your ribcage directly over/in line with the pelvis whenever you can, to restore the natural momentum within your torso: diaphragm over the pelvic floor.
Breathing is your number one tool for healing
You carry it around with you daily. Use it, it’s free, you don’t have to do anything “extra”, plus it will calm and soothe your nervous system. Breathe. It’s SO important. Breathe well, and your pelvic floor health will benefit.
Remember – 5 deep breaths is all it takes to soften you out of fight or flight mode.
Remember when you’re picking up your baby/carseat/squatting down/getting up from the floor blow as you go:
Breathe OUT to lift UP your pelvic floor when you pick up your baby, lift the carseat, sneeze, etc.
Lifting your baby in a carseat places more load on your pelvic floor than any sit up will.
Pelvic floor exercise will help heal any diastasis abdominal separation, it’s your deep abdominal wall that you want to strengthen, and this works together alongside the pelvic floor.
Don’t be afraid to move. But build your INNER STRENGTH adequately before you start high impact work such as running and HIIT.
Can I run while I’m leaking wee?
If you are running and also leaking, or feeling like you’re “falling out” – the simple answer is to stop running. Running while experiencing pelvic floor dysfunction is a bit like wallpapering a newly built wall before the plaster is dry. It’s temporary. Build the strength first, and then test it. Don’t test it simultaneously while you’re still building it, it’ll be like jumping into a boat which has a hole in it.
Download the Squeezy app without delay. 3 minutes, 3 times a day is all it will take to see some difference.
If you are experiencing urinary or faecal incontinence, DON’T IGNORE IT. DON’T LAUGH IT OFF. DON’T JUST REACH FOR A TENA PAD.
PELVIC FLOORS ARE FOR LIFE
Your pelvic floor will not magically get better on its own. It needs attention and care, and then it will work loyally and diligently for you in return.
THINK TENNER NOT TENA: imagine lifting a ten pound note up into your vagina. Hold it for 5 seconds, then drop it down.
Other resources to have a look at: Pilates by Georgia is a physio and Pilates teacher, and on facebook she shares free workouts which are postnatal pelvic floor friendly.
Her website is Home | Pilates By Georgia where you can do a 2-week trial for free or you can pay a subscription for her workouts, some of which are really short and really easy to squeeze in (if you’ll excuse the pun).
Remember – you’re doing an amazing job. And you WILL build up your strength again.
We’ve all heard of ‘postnatal depression’ and it looms large in your imagination as a scary ‘thing’ that might happen after the baby arrives. Increasingly being recognised, though, is the fact that heightened levels of anxiety or low feelings during pregnancy can increase the risk of developing postnatal depression. And perinatal anxiety is more commonly being diagnosed as a standalone condition, separate from postnatal depression. ‘Perinatal’ is the period which encompasses pregnancy and the first year into early motherhood.
Figures released in 2015 by the Royal College of Midwives suggest that up to 20% of women experience perinatal mental illness during pregnancy and in the first year of their babies’ lives. It’s particularly common if you’ve struggled with fertility issues, or have had recurrent miscarriages. The new pregnancy guidelines published by NICE for healthcare professionals suggest that there should be ‘screening questions’ asked at regular pregnancy checks, to look out for warning signs, and support should be offered where needed.
Anxiety is the natural response to times of change: it is a normal human reaction, your brain is hardwired to perceive threats and respond to those threats by asking you to run the hell out of there, or fight, or freeze like a rabbit. When you’re pregnant, your future suddenly looks different, and your brain is physiologically changing to equip you for motherhood, which means that the area of your brain responsible for your fight or flight, the amygdala, actually grows during pregnancy, ensuring that you are more alert for dangers that could affect your baby. A wonderful and miraculous brain adaptation to ensure the survival of the human species… but less handy for modern motherhood when it’s work-related emails, financial worries or the stress of your commute which may be triggering this response day to day, rather than a predator in the bushes.
When anxiety comes out of balance in your emotional “team”, and begins to speak more loudly in your internal dialogue is where it can cause problems. Perinatal anxiety is an issue only where it reaches beyond regular normal ‘worry’, and into something that affects and influences your day to day behaviour and decisions – you’d have to be slightly unusual to sail through pregnancy without ever freaking out about your growing baby, your life ahead, the birth, the fact that you’ve run out of chocolate digestives … No, this is where normal worry tips into something that starts to control your life in a negative way and needs to be managed.
The Maternal Mental Health Alliance describes perinatal depression and anxiety as including constant symptoms such as ‘tumble-dryer mind’, insomnia, feeling tense and irritable, social paranoia, shakiness, blurred sight, racing heart and breathlessness. If you recognise these symptoms in yourself, make sure you chat to your midwife or GP, and please, you’re not alone and there is no shame in seeking help, so don’t suffer in silence.
‘I was surprised by how I seemed to change from being relatively easy going to suddenly very fearful and jittery about everything. I spoke to my midwife about it and apparently it’s quite normal. My GP referred me for a course of CBT (cognitive behavioural therapy) to try and deal with it before it became serious.’ Rosie, mum of 2
What can I do about it?
Question your thoughts – anxiety thrives in the space between your thoughts and your emotional response to them. So, tell yourself that THOUGHTS ARE NOT FACTS if your mind has gone into overthinking overdrive. Journal, when your thoughts seem to be overpowering your brain’s ability to temper their force. And meditate. Offer your thoughts a chance to shine – give them centre stage, and try to observe their acting as if on stage, removed with a curious distance, rather than listen within the emotional whirl.
Share the load and talk to someone about it. It takes confidence to speak up, but try not to feel scared to admit to feeling less than ecstatic if it’s clear that you’re feeling low or anxious most of the time. Even if you’re not able to confide in your partner or open up to your midwife, acknowledge to yourself that you’re feeling this way and try to incorporate managing techniques into your pregnancy – take a regular yoga or mindfulness class, or allow yourself some pampering time – or, simply take five deep breaths. Your breath is the surest way out of fight or flight, as deep breathing physically triggering the balancing parasympathetic nervous system to calm and soothe you. Anything that reduces tension in the body will help you to calm the mind. If you feel happy to, ask to be referred for counselling, which can give you some tools to keep your mental health on an upward trajectory.
‘I did worry about how parenthood would affect me. I’m not a fan of uncertainty and in lots of ways your first pregnancy is one of the most uncertain times of your life!’ Natalie, mum of two
Could it be serious?
If left unchecked and out of balance, perinatal depression can unfold into postnatal depression and really impact on your enjoyment of motherhood, so it’s really worth investigating and taking steps to improve your understanding of anxiety and learning how to soothe yourself into calm.
Around the second trimester, depending on the size of your bump, you will have experienced some degree of abdominal separation: diastasis recti. The rectus abdominis muscle is your “six-pack” muscle. It runs down your front, from your breastbone to your pubic bone: two segments running vertically parallel and intersected by a fibrous band, the linea alba.
In a brilliant design feature of the human body’s adaptability, as your bump grew, the linea alba stretches to allow your baby more space. The two bands of muscle stretch away from the centre. This is most likely to begin at the navel as that is where your baby usually requires most room.
This is a normal structural adaptation, you can’t necessarily prevent it, and neither would you want to – it is a design specially created for your baby’s comfort and growing power. Around 30% of women experience this abdominal separation in the 2ndtrimester, with a further 66% separating in the third trimester. Some research says that 100% of women have some level of diastasis of the rectus abdominis by the third trimester (Gilliard and Brown 1996, Diane Lee 2013). Look at those stats again: 100% of women have this happen at some point to some degree during pregnancy.
The extent of your abdominal separation depends on a number of factors:
Your abdominal tone pre-pregnancy
If you carried more than one baby
If you’ve had more than one baby
If you gain a lot of weight, or if carried a big baby for your height, your baby will have had less space and needed to “pop further out”
Age plays a part: it can be worse if you’re over 35
Lack of regular exercise
Postural load – are you stooping/lifting constantly without care for your technique and form?
Mind the gap
Until quite recently we’ve talked in fearful terms about THE GAP, and the need to “close the gap” postnatally. But actually we now know that it’s not the width of the gap that is the issue: it’s whether or not there is deep tone of the supporting muscles underneath that matters. You could have a 3-finger gap, but as long as your core muscles are firing properly and you can manage your intra-abdominal pressure – the pressure in the space between your respiratory system (your diaphragm) and your reproductive system, placing load out into your belly or down into your pelvic floor – this gap is considered to be “functional”, i.e. not a problem. You may never “close the gap” completely, but as long as you have tone supporting the linea alba, this is ok. So: a problematic diastasis recti is one where there is soft squishy tissue rather than tensile active tissue underneath the linea alba “gap”, therefore not truly supporting your core in movement and leaving you vulnerable to injury and pelvic floor issues.
Diastasis used to be considered a purely cosmetic issue, merely a cause of the “mum tum” or “postnatal pooch” – and dismissed roundly by GPs as a result “ah well you’ve had a baby what do you expect?”. But this is heartbreaking for me to hear of so many women fobbed off when they inquire about DR. There is a direct correlation between a diastasis lacking tone, and the impact and load placed on your pelvic floor and your spine. In essence: if you have a serious gap, you my also experience back pain and/or symptoms of pelvic floor dysfunction.
Diastasis has an effect on the strength and action of your oblique (waist) muscles, and mayhave an impact on the ability of your abdominals to control the pelvis and spine – this in turn could possibly be a cause of back and pelvic pain, if the integrity of your core support isn’t given some scaffolding with strength and conditioning exercises (such as Pilates).
You might have noticed when you were pregnant that when you got out of bed or even up from sitting, there was a strange doming in your stomach, a bit like an alien pushing out, or a Toblerone triangle. As a rule of thumb, you don’t want to see that doming any more. We don’t want to be in a position where you’re putting your muscles under pressure and encouraging it to happen. If you see it when you lift yourself out of bed or off the floor, try rolling over onto your side and pushing yourself up with your hands, rather than using your abdominals.
Continue to avoid ‘regular’ exercises – even if you get the “all clear to exercise” from the GP at your six week check up, unless they have actually palpated your abdominals to check for a DR, please don’t rush back into traditional ab exercises, oblique strengtheners (twisting curl ups and side planks), or any loaded rotation and definitely avoid getting back into running or any other high impact exercise just yet. Erring on the side of caution is always the best policy – despite what some celebrity trainers might suggest on their glossy Instagram feeds.
Excessive abdominal training when a diastasis is present, particularly with twisting movements such as oblique curl ups, can cause a downward pressure in the abdomen through the pelvic floor, which will pull the already weakened linea alba further out to the sides.
Diastasis recti doesn’t always resolve itself on its own, the first 8 weeks are where the main natural healing takes place, and if yours is still a problem gap after this point it needs conscious training and dedicated deep core healing work.
You can hear me chatting about diastasis recti on BBC Radio here. Any questions about postnatal healing – get in touch!
In the first few days and weeks after giving birth you’ll probably feel bruised and sore, whatever birth experience you’ve had. We’re preoccupied with “snapping back into shape” straight after having a baby, and if we buy into this bounce back mentality, the days and weeks after baby can come as a huge shock when celebrities make it look so easy.
The first three months is a time of huge transition and change. It will take this whole time, at least, for your emotions and body to begin to settle into a sense of familiar vaguely confident “normality”. It is totally to be expected that you might feel discombobulated and chaotic. Think of it as starting a new job: you’d imagine that the first few months would be a steep learning curve and to feel way out of your comfort zone. It’s no different for your new job as a mother/mum of two/three.
Some women feel like a superhero, with such a sense of triumph and euphoria that anything seems possible – it can be hard to imagine that you have to take it easy on yourself and rest while you’re riding this high. But equally you may fall into the camp of women who feel like they are depleted and exhausted by the birth and the early days. That was certainly me first time round, and if this is you, please don’t push yourself to hold up a façade of “normal”. Rest. Cuddle your tiny newborn to get the oxytocin flowing and soothe both of your nervous systems, your breathing helps to regulate your baby’s breathing. Snuggle with lots of calming skin to skin in those early days. It takes time to complete your metamorphosis into motherhood, and “normal” takes on a different appearance from now on.
Your uterus contracts back to its original size in the days after giving birth, and these contractions feel quite similar to early labour contractions. They can be stimulated particularly by breastfeeding, and it’s more intense if it’s not your first baby. Establishing breastfeeding is hard, mentally and physically, and is painful initially even if your baby takes to it easily, despite what your health visitor might suggest. You are also very hormonal. So you will be feeling tender and emotional.
Breathing techniques are so valuable for getting you through these intense early days. If it’s your second or subsequent baby, you might be less hit by the enormity of the physical challenge as it’s familiar territory, but you have the added emotional challenge of introducing your new baby into your household of other children and changing the status quo, possibly dealing with demands from your firstborn of “taking the baby back where we got him now” (true story). All of this brings with it lots of joy but also upheaval and mixed emotions. So, revisit deep breathing exercises to soothe your nervous system, every day.
Breathing and pelvic floor awareness exercises are suitable from 24 hours after your birth, whenever you feel ready.
Tearing, and episiotomy care and recovery
It can take up to a month for tears or cuts to heal and for episiotomy stitches to dissolve (small tears with no stitches usually heal faster than this). In that time you’ll probably be in some pain. Having an episiotomy or suffering a tear carries the risk of scarring. Make sure you take painkillers if you need to, and at a time that feels right for you when the area is no longer tender, internal massage is a great way of stimulating the healing process and breaking down the scar tissue, making sure there is minimal effect on your pelvic floor sensation on the long term.
Bathing in warm water and/or using a cushion (a special inflatable cushion can make sitting down more comfortable) can help.
If you’re still uncomfortable after a few weeks, make sure you speak to your midwife, health visitor or GP.
Here are some tips for this early healing period:
Keep the cut/tear and surrounding area clean.
After going to the toilet pour a jug of warm water over your perineum to rinse it. It’s ok to add some drops of tea-tree/witch hazel and lavender to this as well.
Going for a wee can be painful: it might help if you pee in the bath (just before getting out), or in a warm shower.
You might be scared to poo because you’re worried about pressure on the stitches. This fear causes a lot of extra discomfort and emotional distress. You can ask your midwife, GP or health visitor about medication to help you poo more easily. But again, deep breathing should be employed first and foremost.
After having a poo, make sure you wipe front to back, away from your vagina, to keep the stitches clean.
Place an ice-pack or ice-cubes, soaked in tea tree/lavender/witch hazel wrapped in a towel or cloth, onto the affected area, to relieve the pain. Or you can now buy ready made sprays which contain soothing and healing ingredients, such as Spritz for Bitz – which can also be used for caesarean wound healing (and for your baby’s nappy rash).
Restart pelvic floor awareness exercises as soon as you can after birth. They enhance blood circulation, and aid the healing process.
For more postnatal tips, see the Fourth Trimester chapter in my Pilates for Pregnancy book, which so far has 10 5-star reviews! Thank you so much if you’ve enjoyed and reviewed it, I really appreciate the feedback.
Do you have any questions about postnatal recovery? I’m currently writing Postnatal Pilates, which will publish with Bloomsbury next year. Please send me your questions I’d love to try and help xxx
I help women who are experiencing challenges in their postnatal recovery to strengthen their pelvic floor, restore their core and rebuild their vitality, in body AND mind.
It breaks my heart that too many women put up with postnatal physical discomfort and dysfunction, critical inner dialogue and overwhelming anxiety… and think that it’s “just part of being a mum”, or “just the way they are”.
Body image is so intrinsic to our sense of identity and self-esteem – and inner power! If you feel your body has let you down, or you’re feeling weak and uncomfortable every day, this is going to have a dripping tap effect on your energy and happiness levels.
Tapping into your source, unlocking your power can transform your day to day, from your mood to your relationships and productivity.
NOW is the perfect time to focus on your wellbeing and strength. Don’t delay it any more.
Get in touch if you’d like to work one to one or come to a group class, or keep following this blog for more information and advice. Get in touch! I’m always here to answer your questions.
Tell me – what is it that you plan to do with your one wild and precious life?
Pilates for Pregnancy covers the fundamentals of Pilates and includes a progressive Pilates programme tailored for each trimester – focusing on pelvic floor and abdominal strength, posture and health & fitness. Anya Hayes’s insightful exercise guide will help you conquer the physical and mental stresses of pregnancy and improve your pregnancy health, mood and energy.
This is a straight talking, woman-to-woman pregnancy fitness guide with a difference.
· how to optimise the position of your baby for a better birth experience
· how to avoid succumbing to the ‘pregnancy waddle’ and protect your back as your bump grows
· how to deal with second pregnancy posture while knackered and running after/constantly lifting a toddler
· how to minimize the trials of pregnancy on your abdominals, pelvic floor and mind
· how to get into the right mindset for a positive labour, and release tension postnatally
· exactly what cardio exercise is safe and beneficial to you and your bump, and what you should avoid.
It’s a rollercoaster time, the newborn phase. It’s a watershed of all of the anticipation of the past nearly-year, finally holding your baby in your arms (and even more if you’ve been trying for a while). You will probably feel exhilarated and ecstatic. But you also might feel pummelled by your experience, a bit shocked and really, really tired. Be honest with those close to you, and try to be gentle with yourself. Be careful about allowing hundreds of visitors in to see the baby if you really don’t feel up to it. It is an immensely joyful and lovely time taking your baby home, but it is also unprecedentedly stressful, and if you’re trying to establish breastfeeding it can have a detrimental effect to have visitors vying for your baby’s cuddles.
Give yourself a break if you don’t feel 100 per cent happy every moment. Emotions run high and ‘baby blues’ are to be expected a few days after birth, usually coinciding with your milk fully coming in (whether you breastfeed or not) and the exhaustion of 24-hour days taking its toll. If you are feeling very on edge, anxious, or detached and depressed by the time your six-week check comes around, please reach out to your health visitor or GP and ask what support there is available. There should be no stigma to mental health issues postnatally, so please don’t succumb to ‘I’m fine’ syndrome if you’re anything but.
Keep a close eye on your mental health for the first year of your baby’s life – and beyond. Each phase of motherhood brings different challenges; things get easier but something else always gets harder. Your sleep deprivation might accumulate and have an effect on your resilience. So be kind to yourself. Always come back to your breathing tools, and your awareness of the physical symptoms of stress and anxiety.
Now is NOT the time to be thinking about ‘getting your body back’. You have your body now and it’s incredible. Look what it created!
Clients often say to me that in the postnatal period they feel like their body isn’t their own. You might have loved your baby bump, and now your belly wobbles like a deflating water balloon. It’s hard to come to terms with, and you must be patient with yourself. Internally it feels like everything’s been swapped around, as if all the furniture in your house has been surreptitiously rearranged, and maybe a supporting wall has been knocked down. I will not hear of you wanting to get a at tummy or be back in your skinny jeans. This is about connecting to your body, re- establishing your breathing, your pelvic floor, your awesome abdominals that have housed your baby for the past nearly-year.
You might feel low or even despairing about your postnatal body. But please, this time of recovery is so crucial that you will reap the most rewards if you don’t rush it. Try to go against the societal grain and cultivate some compassion for your body, which has done so much miraculous work over the past year. IT TAKES TIME to recover your strength. And, like it or not, HIIT, ‘body shreds’ and Power Pramming are not the way forward initially, which can be a bitter pill to swallow if you were a gym bunny pre-children.
Be patient with yourself. Be the tortoise not the hare. It is really important to take the time to recover well and fully from childbirth, to help prevent problems with future pregnancies and in your pelvic floor for life.
You have a baby. You take it relatively easy for the first 6 weeks, maybe doing the odd squeeze of your pelvic floor (clenching your buttocks hopefully and raising your eyebrows?) when you remember/can be bothered, but you’re itching to get back into it and “lose the baby weight”, “get your body back”. Pictures of Kardashians pinging back into their pre-baby shape make you feel like you’re lagging behind, being lazy, stuck somehow “doing nothing” under your baby when there are other more important things to do. You feel like 6 weeks is a LIFETIME before you can be “signed off as back to normal” and ready to get stuck into regular activity, sign me up for baby Zumba now please!
Even if you’ve been “signed off” at your 6-week check, this should be seen as the START line of the marathon of your body healing itself, not the finish line. Your 6-week check is often cursory and currently skips over some fundamentals of your healing.
The 6-week check usually marks the formal end of maternity care, and you may think woo hoo I’m good to go, hot baby spinning Zumba here we come! – but at six weeks your body is not yet healed. Too often the GP only has time to offer you a quick glance and doesn’t ask you in depth about pelvic floor healing or check your abdominals for separation (see below). So you shouldn’t take it as read that you’re now all clear to get into high impact exercise – particularly if you weren’t an avid exerciser before pregnancy.
Six weeks leaves just enough time for your organs to settle back to their original position once baby has evacuated that space, and the first stage of soft tissue healing. And potentially it takes much, much longer if you’ve had a caesarean. It can take several months for the abdominal and pelvic muscles to recover fully, and for the connective tissue to completely firm up. Your body is healing, there is so much going on under the skin that you can’t see, it needs nurturing and kindness.
Running and HIIT exercise appeals to mums because it requires no equipment, costs nothing, and can be crowbarred fairly easily into a suddenly-chaotic yet full-of-nothing-much day. You think getting back into it will make you feel great, lose all the weight, find your mojo. And it might. There’s no doubt about the importance of exercise for wellbeing. But going straight into high impact activities like running if “my 6-week check was fine” (did the doctor specifically say anything about exercise?) may not be the best plan for your long term healing.
Breathing is the most crucial starting point for your recovery, physically and mentally. Sooo boring, right? Well, your breathing enables you to release tension and anxiety, to allow your body space to recover from your birth experience, to move you from “fight or flight” into “rest and digest” mode. Breathing is intrinsically connected with the efficacy of your abdominals and pelvic floor, as the diaphragm has to learn how to communicate with your pelvic floor now that your baby is no longer hogging the space between them. Breeeeathe, wide and full into your belly, allow your diaphragm to fully descend and open and it will stimulate the conversation between the pelvic floor with its symmetrical rise and fall motion. It’s the most overlooked healing tool we have: it’s free, you’re doing it anyway might as well make it count, it doesn’t take any extra time ladies.
Diastasis whatsi? Diastasic recti – abdominal separation. Your rectus abdominis – your six-pack muscle, has separated during pregnancy due to stretching of the linea alba ‘fascia’, the connective tissue that holds the two bands of muscle together, sort of like unzipping at the front. Trying to flatten the mum tum with sit ups is not the solution as it will make the separation worse. We need to strengthen the deeper stabilising muscles: the pelvic floor, your corset muscle the transversus abdominis, and, fundamentally, get the diaphragm firing properly with proper breathing.
I’ll say it again because it’s so important: NO SIT-UPS. NO CRUNCHES. NO PLANKS. These are strictly contra-indicated in the early months of your postnatal recovery, due to weaknesses caused by abdominal separation – and if you’ve never been checked for ab separation, this rule applies for years after postnatally. If you’ve got diastasis it is going to cause problems however “new” or old a mum you are. ‘Ab exercises’ cause an increase in intra-abdominal pressure, which in turn increases the load placed on your weakened pelvic floor – sort of like building a loft extension on top of a house where you’ve knocked down a load-bearing wall. It’ll cause back pain, may exacerbate pelvic floor problems, it’ll make your foundation weaker not stronger.
If you do go to a buggy running-type group, or attend any fitness group in the year after your baby, your instructor MUST check your abdominals for separation and at the very least ask you in detail about your birth experience, how your pelvic floor is feeling, whether you experienced pelvic pain during your pregnancy. If the PT or instructor omits any of these essential postnatal duty-of-care issues, and particularly if they launch into AB EXERCISES, planking, sit-ups, leg lowers, flat tummy exercises etc., DO NOT DO THIS CLASS. Run, run away (slowly and with care).
Bum deal. Your pelvis has taken most of the burden of carrying your baby and probably also provided the exit route, so we need to give it some strong scaffolding. Hormones are still flooding your system, which keep your ligaments and joints unstable for up to nine months (and if you are breastfeeding, potentially longer), so it’s important to regain strength in your glute muscles, in order to stabilise your lower back and hips. If they aren’t firing on all cylinders you’re more likely to experience low back pain or have issues with your hips, knees and ankles. Strong bums are particularly important if you want to ultimately get back into high-impact movement such as HIIT and running…or just lifting and day to day craziness with your minis – I mean, that can be a HIIT workout in itself, right?
Posture matters. Everything hinges on your alignment in terms of your body systems working effectively post-birth. No amount of pelvic floor exercise will be truly effective if your alignment is poor and you’re not breathing fully. You do a lot of lifting and bending when you have small children and it’s important to soften and balance your body – especially if you are breastfeeding.
I wet myself! LOL! IT’S NOT FUNNY. The main thing to remember about your pelvic floor after birth is that you should not suffer in silence, or laugh it off. There is absolutely no evidence to suggest that pelvic floor issues get better if they are ignored. If you are struggling with pain, discomfort, lack of sensation, a feeling of heaviness or ‘bearing down’, or even if things simply don’t feel ‘normal’ – not asking for help and laughing it off only means that the problem will definitely get worse over time.
Think about your 70-year old self and how you want her to feel. There is a real risk of pelvic organ prolapse postnatally, and it is so important to strengthen your pelvic floor to increase your chance of avoiding this, particularly if you want to have more children. If you feel any sensation of your insides ‘falling out’, do not ignore this. A prolapse is when the uterus, bowel or bladder descends into the vagina. Go to your GP and ask to be referred to a women’s health physio.
I had a C-section, pelvic floor exercises don’t apply to me. Sadly you don’t get let off the hook. Your pelvic floor has provided a neat pillow, punch bag and trampoline for your baby for 9 months. It needs some attention even if it didn’t serve as the exit turnstile.
Whatever birth you had, start your pelvic floor exercises as soon as possible. The sooner the better. BUT IT’S NEVER TOO LATE. So start now. NOW. If you had a perineal tear, whatever grade, begin these exercises without delay, as they’ll promote healing, send blood circulation to the area, reduce swelling, increase sensation and help you to regain your strength and function.
To do your pelvic floor exercises correctly: lift your back passage – imagine you are trying to stop breaking wind – then travel the engagement forward as if you want to stop the flow of wee, squeeze and lift forward and up.
Try not to hold your breath: lift up with an exhale, and then allow the entire pelvic floor to fully open, soften and relax on the inhale. Do a few repetitions, slowly and intentionally, a few times every day with this breath pattern. Then progress to doing some quickly. Squeeze and repeat 10 times, breathing normally without holding your breath, and always fully releasing and resting with an inbreath at the end.
Remember that when you lift your pelvic floor there should be no clenching or tension anywhere else: bum, shoulders, jaw, inner thighs. It’s an internal engagement. A strong pelvic floor is the key to healing your mum tum.
Look at the Squeezy app for more guidance and information about pelvic floor exercise.
Pilates is a perfect postnatal activity to strengthen your core and bum, to release tension – but it has to be the right kind of Pilates. Check your instructor has experience and the right credentials for working with mums.
Yoga is brilliant to. But as above.
Swimming is low impact yet surprisingly challenging, and meditative – just keep swimming just keep swimming just keep swimming….
And walking. Especially in green spaces. Walking is very healing and strengthening.
Your postnatal mojo is so linked to how your body FEELS and how you’re functioning. If you’re weeing when you exercise, or even when you cough and sneeze, that’s going to make you feel like shit, and make you scared to speak up about it or to continue to exercise, which perpetuates a negative cycle for your wellbeing.
Depletion in body: make no mistake, pregnancy withdraws all you got. It takes you well into your overdraft of energies, nutrients, minerals, strength. And then you don’t often choose to make deposits back into your account once baby is out (the “bounce back”!).
Your gut health may well be affected by your birth experience – antibiotics, caesarean birth – which will compromise your absorption of nutrients from your food. And crucially, may compromise your production of serotonin – the hormone of JOY, which is largely produced in the gut and therefore arguably could be one of the missing links in some out of the blue experiences of postnatal depression.
You’re not sleeping well, and probably not drinking enough water so you’re dehydrated. And you may only be eating toast, biscuits and mainlining coffee anyway, so your poor gut doesn’t have that much to work with.
Postnatal depletion is not depression. But it can make you feel generally a bit meh and crap. Which lends itself to becoming depression if left unchecked over time. The most basic form of selfcare is to tell yourself that you matter, to feed and water yourself adequately. How do you FEEL? Are you strong? Are you strong enough to carry a toddler in your dungarees like a sling for a mile when they refuse to go in the buggy?
It’s normal not to feel amazing all the time. But if it’s affecting your every day and you just feel “not right”: this is the tipping point. Check your PHYSICAL needs today: drink enough water, breathe properly and fully – this will be affecting your mind and spirit too. Our body image is so intrinsic to our happiness and identity, and postnatally this can take a real kicking.
It takes time to heal and regain your strength, you are only human, you’re not a Kardashian. It’s not frivolous to prioritise you and getting your body back safely and effectively. If you return to sit-ups, planks, running, HIIT too soon you can do more harm than good.
So ladies please: drink enough water, remember to breathe, and if you’re at all worried, ask your GP to refer you to a women’s health physiotherapist. Look after YOU!
JOY – so what did you used to do for “exercise” when you were little? Do you remember what you did to “keep fit” when you were a kid? I’d imagine that instead of “keeping fit” you just “were normally active”, you used to run, climb, jump, skip, play space rockets just for the helluvit? Am I right? When was the last time you played space rockets just for the helluvit and actually broke into a sweat?
Human beings were built for movement. We are supposed to climb, twist, jump, roll, squat in our daily activities. We are designed to walk for miles and miles a day. We are fairly unique in the animal kingdom for being capable of a huge range of physical activities, from climbing trees and swimming to trekking over mountains and riding horses. And yet the modern adult human has a fraction of the strength that his/her prehistoric counterpart would have needed in their every day existence. Simply because we let it go to waste. Our muscular and skeletal structure is exactly the same. Modern life has made us comfortable, given us remote controls, escalators and email, and has enabled us not to have to get up and move so much. But that has had hugely detrimental effects on our physical and mental health.
One of the things that I most love about the Model Method Online is that it has a focus on physical and mental health equally, and a full acknowledgement that the two are inextricably linked. This is not a programme about honing your waist, toning your butt or losing weight, although there is likely to be a side-effect of that happening – it is not in the quest for a “perfect body” but instead in the intention for a stronger, happier you. What’s not to love about that?
I was really surprised by how much I loved the HIIT. Hollie Grant, the Pilates PT, has blogged about the Top 5 Misconceptions about HIIT and I have to confess I really wasn’t that keen on the idea of HIITing myself up. I felt like it was a bit aggressive and too jumpy. I felt like maybe I was a bit too old for HIIT. I knew that I might be a bit too lazy. And I was a bit worried about my dodgy knee – basically this is the soundtrack in my head of the SELF SABOTAGING GREMLIN. Do you have such a gremlin? I bet you do. Next time you hear its voice, why don’t you question it rather than listening to it and allowing it to dominate your actions?
The first time I did the Model Method HIIT workout video, I’m not going to lie, it kicked my arse. I was absolutely knackered and sweating buckets. I was slightly malcoordinated and couldn’t keep with all of the moves. But I LOVED it. It tapped into those slightly crazy games you used to play at primary school where you just run and jump without any particular rules. And you have to run to the water fountain, gobble up your water as your breath is rapid and your cheeks are red. And you feel amazing and joyful but as you’re a kid you don’t even know that that’s not a regular state of mind any more once you’re in the adult world of mortgages and President Trump.
You get 7 workout videos: 3 30-minute SWEAT, 2 15-minute STRENGTHEN, 1 30-minute Pilates core workout. There is a STRETCH sequence that you can tag onto any of the above – but Hollie recommends that if you have time you add it onto the HIIT workout. Honestly I rarely had time to do a full 45 minutes and so I used to do the stretch sequence throughout the day when I could fit it in.
I found that the HIIT workouts left me feeling elated and I regularly laughed or found myself beaming widely without even thinking twice, simply because it was FUN. Yes, there were some moves that my dodgy knee didn’t love, but I could avoid those without skipping the whole workout.
So, HIIT gets a massive TICK from me. Thank you Hollie.
If you’re anything like me, you’re constantly looking for ways that you can supercharge/begin a “fitness routine” around an already chockablock timetable involving juggling children, life, home, work. Since having Freddie, I’ve really struggled to get back into the fitness groove: I did the London Triathlon when he was 6 months old – I had signed up because after my first birth experience I really lost all my fitness mojo, had put on a lot of weight and had a very traumatic birth experience which meant I had to start from rock bottom in terms of building up any physical strength, and I became incredibly disheartened at how hard it was. So I wanted to avoid sinking into a similar slump second time round… plus I’m the kind of person who really needs something to give me an accountability framework for my exercise otherwise it too easily is pushed down my list, and I listen to the exhausted self-saboteur on my shoulder who whispers “you’re too tired”, “you haven’t got time”, “you’ve got too many other things to do to take 15 minutes out to do a workout”, “you’ve got other things you could be doing”. Sure enough, having signed up for a triathlon meant that I really did drag my breastfeeding-heavy boobs out most evenings for a swim or a jog when Freddie was little.
But, my hormones had compromised my joints and I probably was a bit too tired for triathlon training in reality, and I ended up injuring my knee – an injury that still plagues me now, very VERY annoying. And since the triathlon, the self-saboteur has been back in force. In some ways it’s easier to get out of the house when your baby is really small. Once there’s a child and a rampaging toddler, time seems to be sucked into a vortex much more easily. No time, no energy, can’t do it…
While postnatally it’s true, you really do need to listen to your body and give yourself a break if you’re tired, and you MUST be properly checked out for diastasis recti – abdominal separation – and pelvic floor issues – it’s really NOT normal or ok to be in fear of weeing while you exercise – before you start an exercise programme. But you also need to make sure that your inner sloth isn’t talking over your inner gazelle. Exercise is so so important for your mental health, for your energy, for your positivity, for your sense of self and confidence. It encourages you to breathe, it gives you space mentally, and physically if you exercise outdoors. It really is an elixir. But way too easy not to prioritise.
Freddie will be 3 in January, so I’d be hard pushed to get anyone to consider me “postnatal” (although, I personally believe that if you’ve ever had a child, you are “postnatal” in terms of exercise due to the massive demands that pregnancy, birth, mothering place on your body), and I’ve been feeling really low about how I am still so stodgy and can’t seem to make a fitness programme stick effortlessly into my life.
I teach Pilates, and every day I focus on my movement, I do probably more yoga and Pilates day to day than the average mum, and I am evangelical about the fact that EVERYONE should do Pilates and take Pilates into their regular movement patterns to overturn the demands and imbalances of modern life. So I know I’m not starting from nothing. But I am also incredibly lazy and I let myself get away with the bare minimum effort without someone standing over me. I’m not a runner (I could blame the knee but actually that’s now just a good excuse). I tend to find excuses to avoid breaking up a sweat. But why? I used to love playing hockey and football, tennis, anything that involved running and teamwork at school. Swimming – I think I was a fish in a former life. Horseriding was my happy activity. Play. I used to love to play. Where’s the play in adult life? Exercise seems to be a TO DO, a SHOULD rather than a WANT TO. Something that you have to “get over with”.
And fitting it into life effortlessly…..well, maybe that’s the nub: it’s an unrealistic demand. It can’t really. be effortless – what on earth that is worth having has been effortlessly gained? Hmm. So, it was time to put my money where my waist is, and see if I could find a new habit and fire for regular aerobic exercise through committing to the Model Method Online.
Check out how I got on with the programme and whether it managed to stoke those fitness fires or whether I’m still a tired ol’ sloth lounging in my sleep-deprived inertia…..